Human Papillomavirus DNA and mRNA Prevalence and Persistence in a Cohort of Human Immunodeficency Virus Positive Women in Ireland
J Mc Inerney, H Keegan, L Pilkington, O Sheils, CM Martin, A Loy, S Delamere, M Barrett, M Griffin, F Lyons, F Mulcahy, JJ O'Leary. University of Dublin, Trinity College & Coombe Women and Infants University Hospital, Dublin 8, Ireland; St. James' Hospital, Dublin 8, Ireland
Background: Human papillomavirus (HPV) infection is necessary for cervical neoplasia and cancer development. HIV positive women are known to suffer increased prevalence of HPV infection, persistent HPV infection and thus increased cervical disease. With anti-retroviral therapy increasing the life expectancy of HIV positive women, the risk of developing cervical disease will also increase. In this study, we examined a HIV positive cohort of women for high-risk HPV (HR-HPV) DNA prevalence, HPV mRNA oncogenic expression and cytological status in relation to clinical and socio-demographic data. This study forms part of the CERVIVA research consortium funded by the Health Research Board, Ireland.
Design: 300 HIV positive women were recruited to the study through the Genitourinary and Infectious Disease Clinic at St James' Hospital, Dublin. PreservCyt™ cervical smears were taken at time of recruitment and at 12-18 month follow-up periods. Clinical data was recorded for each patient. Cytological diagnoses were made according to BSCC guidelines. HR-HPV DNA positivity was determined using Hybrid Capture II assay (Qiagen Ltd., UK); with HPV mRNA expression detected using the PreTect™ HPV Proofer assay (NorChip AS, Norway) for 5 HPV types (16, 18, 31, 33 and 45).
Results: We found a HR-HPV DNA prevalence of 49%, a HPV mRNA prevalence of 20% and an abnormal cytology rate of 25%. In women with cytological abnormalities HR-HPV prevalence was 88% and HPV mRNA prevalence was 40%. HPV 45 was the most common mRNA type found followed by HPV 18, 16 or 33 and 31. To date HR-HPV DNA rates were 53% (26/49) at baseline and 45% (22/49) at 12-18 month follow-up. HPV mRNA rates were 21% (10/48) at baseline and 23% (11/48) at follow-up. In women with CD4 counts (>200 x 106/L) HPV DNA and mRNA rates were 49% and 18% respectively with HPV DNA and mRNA rates in women with CD4 counts (<200 x 106/L) being 78% and 44%.
Conclusions: HPV mRNA prevalence of 20% is higher than normal populations but not unexpected due to the increased persistence of HPV infections in HIV positive women. There is a direct correlation between low CD4 counts (<200 x 106/L) and increased HPV DNA and mRNA positivity.
Tuesday, March 23, 2010 9:30 AM
Poster Session III # 79, Tuesday Morning